Paronychia

Re: Paronychia

Hannah Ridgwell — Mon, 15 Mar 2010 18:46:59 GMT

Thanks everyone that's brilliant. There has been pus present beneath many of the loose nails and swab results said P. aeruginosa. Will keep you up to date with how dog gets on, would like to avoid having to amputate P3 but at least I know where to go from here.

Re: Paronychia

Vikki Moran — Mon, 15 Mar 2010 08:08:29 GMT

thanks. i have gone with EFA supplementation with the briard, as her owner hasn't got the funds to pay for any histology, and with the greatest respect in the world, he really is not the brightest bulb in the box, so trying to explain that there was something wrong with the dogs nails was hard enough!

the JRT I saw is a bit more interesting - she dropped all her nails within 48 hours late last summer, had pain relief and antibiotics, then they all appeared to grow back well, they seem pretty strong and healthy now, but last week she was presented with erosions on her pinnae - they were about 3-4cm diameter, in the centre of the inner surface of the pinnae. otoscopic examination revealed no otitis. in fact they were probably the cleanest ear canals i have ever seen. She's on ceporex and preds, and seems to be responding well, but i'm not sure what exactly is going on there. any ideas? are the two related? is this a form of lupus that I'm not familiar with?

Re: Paronychia

Adi Nell — Sun, 14 Mar 2010 20:30:23 GMT

Hi,

Multiple nails on multiple feet - top of the list by a very long way is symmetrical lupoid onychodystrophy as mentioned by others earlier on. There are other ddx but none will routinely cause all the nails to be shed over the course of a couple of weeks to a month or two. Dogs usually come in repeatedly with nails lifted either completely or almost completely off with remarkably little sign of pain or distress.

Best rx is remove all remaining nails under ga - they really do come off easily (if you need a lot of force then it ain't lupoid onych...!). Simply grip the nail with artery forceps and rotate around the long axis. Lots of pain relief, short course abs, bandages for a few dd to protect the feet. You can do your p3 amputational biopsy at the same time if you feel it's necessary.

The nails will grow back but are usually weaker, slightly deformed and more brittle than usual. I've had moderate "success" with efa supplementation (2x normal maint dose), but there are many protocols out there.

To make an absolute dx you need to biopsy p3, ideally a dew claw, before the nail is lost. You also need a really good pathologist. All my skin stuff goes to David Shearer at Finn (can I say that?). He's not only a great dermatohistopathologist but he's got loads of clinical experience and he's a great chap to ring to discuss a case after you get his report.

Hope that's of some use?

Cheers,

Adi

Re: Paronychia

Vikki Moran — Sun, 14 Mar 2010 19:55:06 GMT

i have seen a few of these over the last year. i had never seen it at all before last summer, then i've seen one GSD, 2 JRTs, one briard and a Cocker. I've basically done as richard says, remove any remaining ones (if they were easy to), antibiotics, pain relief and watch them grow back.

Re: Paronychia

Richard Carter — Sun, 14 Mar 2010 18:13:43 GMT

If multiple nails on different feet without signs of infection (pain, pus etc), sounds like condition seen in GSDs where have reaction to nail beds and lose all nails - as usual I'm not near any textbooks to give you the scientific wording - best rx ga, remove remaining nails (will be surprised at how easily come away) and let grow out again. May want some a/bs; pain relief if complicated with infection but usually not necessary - cleaning usually ok. Some people also recommend biotin suppl but unlikely going to save remaining nails and regrowth new nails usually good.

Re: Paronychia

Andre Escudeiro-Vieites — Sat, 13 Mar 2010 19:22:35 GMT

[quote user="robloxley"]

The Journal of Veterinary Dermatoolgy has a paper describing onychobiopsy without onychectomy: http://www3.interscience.wiley.com/journal/119095558/abstract .

[/quote]

Have you tried the technique?. Is it simple?. Sorry I could only access the abstract from the link

Re: Paronychia

Hanna Bennett — Sat, 13 Mar 2010 17:26:12 GMT

i have a greyhound with lupoid onchodystrophy -unconfirmed but clinically very suspicious - and we cut all his nails right back and started him on EFAs. was very sore for a while, but then he was everytime he pulled a claw, kept him on happy drugs for a couple of weeks. six months later he has stubby little claws but they are solid, and he hasn't had any problems since. fingers crossed...

Re: Paronychia

Rob Loxley — Sat, 13 Mar 2010 16:26:22 GMT

If the dog has a dew claw then that would be my biopsy site of choice. The owner needs to weigh the chronic, recurring pain that the dog may be suffering against the controlled, short term pain of a biopsy, to get a proper diagnosis to allow best treatment.

The Journal of Veterinary Dermatoolgy has a paper describing onychobiopsy without onychectomy: http://www3.interscience.wiley.com/journal/119095558/abstract .

Some might argue trial tx with EFAs, niacinamide +/- doxycylcine, +/- food trial.

Re: Paronychia

Andre Escudeiro-Vieites — Sat, 13 Mar 2010 15:25:39 GMT

I vote for lupoid onychodystrophy, but you will have to amputate the 3rd phalange with the nail and send it to a pathologist to find out. Don't try sending a nail(even a close trim) because it won't be diagnostic

Re: Paronychia

Mark Frost — Sat, 13 Mar 2010 14:59:05 GMT

Remember a colleague seeing one in a GSD that ended up on a lot of steroids... seen two working cockers in about two weeks (unrelated and different owners!) a few months back with the same, removed almost all their nails under sedation and covered with abs, plus added coatex type supplements, both doing well at present but owners aware p3 amp required for diagnosis (and not keen at present) and anything other than that is speculative treatment. Both young dogs.. under 3yrs. Some guidance from BSAVA derm manual suggested a variety of 'possible' treatments but difficult without diagnosis.

Re: Paronychia

Vikki Halliday LLB — Sat, 13 Mar 2010 14:26:08 GMT

Saw one in a lurcher/whippet type dog that turned out to be familial(?) zinc deficiency. Did have to amputate P3 to get the answer though. Blood tests were i think indicative at the time but not confirmatory.

Re: Paronychia

Rob Loxley — Sat, 13 Mar 2010 12:29:14 GMT

Trauma, infection (usually secondary), lupoid onychodystrophy, pemphigus etc.?
Think you probably need a biopsy by P3 amputation?